Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0016382 (flushing)
 6,387 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Adenosine thallium-201 myocardial scintigraphy is a promising test for coronary artery disease detection, but its safety has not been reported in large patient cohorts. Accordingly, the tolerance and safety profile of adenosine infusion were analyzed in 607 patients (351 men, 256 women, mean age 63 +/- 11 years) undergoing this test either because of suspected coronary artery disease (Group I, n = 482) or for risk stratification early (5.2 +/- 2.8 days) after myocardial infarction (Group II, n = 125). Adenosine increased the heart rate from 74.5 +/- 14.0 to 91.8 +/- 15.9 beats/min (p less than 0.001) and decreased systolic blood pressure from 137.8 +/- 26.8 to 120.7 +/- 26.1 mm Hg (p less than 0.001). Side effects were frequent and similar in both groups. Flushing occurred in 35%, chest pain in 34%, headache in 21% and dyspnea in 19% of patients. Only 35.6% of Group I patients with chest pain during adenosine infusion had concomitant transient perfusion abnormalities, compared with 60.7% of Group II patients (p less than 0.05). First- and second-degree AV block occurred in 9.6% and 3.6% of patients, respectively, and ischemic ST changes in 12.5% of cases. Concomitance of chest pain and ischemic ST depression was uncommon (6%) but, when present, predicted perfusion abnormalities in 73% of patients. Most side effects ceased rapidly after stopping the adenosine infusion. The side effects were severe in only 1.6% of patients and in only six patients (1%) was it necessary to discontinue the infusion. No serious adverse reactions such as acute myocardial infarction or death occurred.(ABSTRACT TRUNCATED AT 250 WORDS)
J Am Coll Cardiol 1991 Sep
PMID:Tolerance and safety of pharmacologic coronary vasodilation with adenosine in association with thallium-201 scintigraphy in patients with suspected coronary artery disease. 186 36

The carbon monoxide complex of ascorbate-reduced dopamine beta-hydroxylase has been prepared and characterized by Fourier transform infrared, fluorescence, and x-ray absorption spectroscopies. CO has previously been shown to be a competitive inhibitor with respect to O2, and binds to only one of the two copper atoms/active site (Blackburn, N. J., Pettingill, T. M., Seagraves, K. S., and Shigeta, R. T. (1990) J. Biol. Chem. 265, 15383-15386). Thus, it acts as an excellent probe of the O2-binding site. A single C-O infrared absorption band is observed at 2089 cm-1, shifting by 46 cm-1 to lower energy on substitution with either 13C16O or 12C18O. The 13C isotope shift is reversed to the position expected for 12CO upon vacuum flushing with 12CO gas, indicating that formation of the CO adduct is a fully reversible process. Binding of the substrate tyramine does not eliminate the infrared peak but causes a 3-cm-1 shift to lower energy. On the other hand, binding of a bifunctional inhibitor which cross-links the substrate and O2-binding site does eliminate the CO peak. These data, in conjunction with the competitive nature of CO binding with respect to O2, identify the CO-binding site as the O2-binding site, and place it in close proximity to the substrate-binding site. CO-dopamine beta-hydroxylase exhibits no luminescence in the visible region, suggesting a structure different from carbonmonoxy hemocyanin, and in all probability mononuclear. Analysis of extended x-ray absorption spectroscopy data is most consistent with an average coordination per Cu of 2-3 histidines, 0.5 CO, and 0.5 S atoms as ligands, and absorption edge comparisons indicates pseudo-4 coordination as the most likely geometry at each Cu(I) center. The results can be interpreted by a model involving inequivalent 4-coordination at each Cu(I) center in the CO adduct with CuAHis3S...CuBHis2CO-X as the coordination most consistent with all of the data.
J Biol Chem 1991 Sep 15
PMID:Carbonmonoxy dopamine beta-hydroxylase. Structural characterization by Fourier transform infrared, fluorescence, and x-ray absorption spectroscopy. 189 98

Sterilization with low temperature steam and formaldehyde is a well-known process in many European countries, but little known in the United States. It sterilizes reliably and reproducibly at temperatures greater than or equal to 65 degrees C. With a well-designed cycle, it leaves residues of formaldehyde on sterilized items below 5 micrograms/cm2, measured on a standard filter paper. Formaldehyde levels in air near the autoclave are well below official exposure limits, if at all measurable. Occurrence of late growers in bioindicators, and penetration of the sterilizing media into long narrow lumina, should be validated for new processes. Automated cleaning and disinfection in closed washer-disinfectors and flushing disinfectors are likewise processes relatively little known in the United States. Disinfection is achieved by a final rinse with hot water or steam. Washer-disinfectors are used for surgical instruments, nondisposable anesthesia and other equipment, flushing disinfectors for nondisposable bedpans, wash-bowls, urinals, and similar equipment. They clean well, washer-disinfectors excellently so, and disinfect reliably. With the use of such equipment in wards, surgical departments, and other areas, reliance on chemical germicides can be dramatically reduced and disposables can be replaced by disinfectable nondisposables.
Am J Med 1991 Sep 16
PMID:New technology for sterilization and disinfection. 192 74

The major use of N-acetylcysteine in clinical toxicology is in the treatment of acetaminophen (paracetamol) overdosage. The hepatorenal toxicity of acetaminophen is mediated by a reactive metabolite normally detoxified by reduced glutathione. If glutathione is depleted, covalent binding to macromolecules and/or oxidation of thiol enzymes can lead to cell death. Oral or intravenous N-acetylcysteine or oral D,L-methionine mitigates acetaminophen-induced hepatorenal damage if given within 10 hours, but becomes less effective thereafter. In vivo, N-acetylcysteine forms L-cysteine, cystine, L-methionine, glutathione, and mixed disulfides; L-methionine also forms cysteine, thus giving rise to glutathione and other products. Oral therapy with N-acetylcysteine or methionine for acetaminophen poisoning is contraindicated in the presence of coma or vomiting, or if activated charcoal has been given by mouth. Nausea, vomiting, and diarrhea may also occur as a result of oral N-acetylcysteine administration. Anaphylactoid reactions including angioedema, bronchospasm, flushing, hypotension, nausea/vomiting, rash, tachycardia, and respiratory distress may occur 15-60 minutes into N-acetylcysteine infusion (20 hours intravenous regimen) in up to 10% of patients. Following accidental intravenous overdosage, the adverse reactions of N-acetylcysteine are similar but more severe; fatalities have occurred. A reduction in the loading dose of N-acetylcysteine may reduce the risk of adverse reactions while maintaining efficacy. Administration of N-acetylcysteine for a longer period might provide enhanced protection for patients in whom acetaminophen absorption or elimination is delayed. N-acetylcysteine may also have a role in the treatment of toxicity from carbon tetrachloride, chloroform, 1,2-dichloropropane, and other compounds. The possible use of N-acetylcysteine and other agents in the prevention of the neuropsychiatric sequelae of acute carbon monoxide poisoning is an important area for future research.
Am J Med 1991 Sep 30
PMID:Use of N-acetylcysteine in clinical toxicology. 192 4

Prothrombin time and activated partial thromboplastin time were measured in two groups of 30 patients each. Blood sampled from an arterial line after various discard volumes and from a central venous line were compared with direct venipuncture control samples. The arterial line flushing solution contained 1 unit of heparin per ml in group 1 and 2 units per ml in group 2. Our results confirmed that clotting studies carried out on blood samples from an arterial line or central venous line correlate well with those obtained from a venipuncture sample. The only exception was activated partial thromboplastin time in group 2 patients when the discard volume from the arterial line is only 2.5 ml above the deadspace volume of the connecting line. At least 5 ml of discard volume must be withdrawn before sampling, to obtain reliable results.
Anaesthesia 1991 Sep
PMID:Intra-arterial blood sampling for clotting studies. Effects of heparin contamination. 192 68

The correlation among degrees of alcohol intoxication, facial flushing, blood alcohol concentration (BAC) and blood acetaldehyde level was studied in 117 male alcoholic patients who underwent various tests to assess alcohol influence. Blood samples were collected and alcohol and acetaldehyde levels were determined. BACs ranged from 29 to 577 mg/dl in all patients and from 200 to 299 mg/dl in 48 of them. Fifty-one patients could stand erect (mean BAC [+/- SD] = 189 +/- 80 mg/dl), while 48 showed apparently normal reaction to a walking and turning test (mean BAC = 192 +/- 78 mg/dl). Some of the cases having BACs over 300 mg/dl could still stand and walk while others with BACs under 100 mg/dl already showed psychomotor impairment. Facial flushing was recognized in 75% of the subjects. Acetaldehyde concentrations in 27 patients ranged from 24 to 147 micrograms/dl. Appearance of facial flushing was correlated with relatively high concentrations of blood acetaldehyde. Seven out of 10 healthy volunteers given 1.6 to 2.0 g/kg of alcohol as a control could do nothing but sleep after reaching peak BAC (mean = 232 +/- 21 mg/dl). These findings are taken to indicate a great difference in response to alcohol between alcoholics and healthy men. This study is the first to report the occurrence of facial flushing and raised blood acetaldehyde concentration among Japanese alcoholics.
J Stud Alcohol 1991 Sep
PMID:Degrees of alcohol intoxication in 117 hospitalized cases. 194

The efficacy of a dental unit equipped with a system that disinfects and sterilizes the water tubing by flushing with glutaraldehyde was evaluated by inserting Bacillus megaterium spores and Pseudomonas and Moraxella species into the water tubing. Up to 10(8) Pseudomonas and Moraxella organisms were killed during the disinfection cycle, but Bacillus megaterium spores were not. Up to 10(5) spores were eradicated by the sterilization cycle, although the system did not consistently kill 10(8) spores. The water tubing of the new unit was not naturally colonized by water bacteria during an 8-month period prior to the study. Evidence suggested that this was due to antimicrobial activity associated with the plastic tubing; therefore, microbial contamination of new dental units, irrespective of their design, would not be expected, until the inhibitory factor in the plastic tubing has leached out.
Quintessence Int 1991 Sep
PMID:Evaluation of a dental unit with a built-in decontamination system. 194 48

Elevated drug concentration (DC) can be caused by intentional or iatrogenic overdoses and sampling technique errors. This study examined, in vitro, technique factors that can cause and prevent false elevations of DCs when drugs are administered through the catheter lines from which blood samples are later taken for DC analysis. Digoxin, aminophylline, and phenytoin were administered through central catheters in concentrations simulating those used clinically. Drug solution remained in the lumen for a time similar to that encountered clinically, then either remained in the tubing or was flushed out with 5 ml of normal saline (NS). After 6 h, a 5-ml sample was withdrawn for DC analysis (the tip of the catheter placed in NS, which represented blood supply). Prior to final sample withdrawal, 5 ml of NS was drawn through half of the lines and discarded to simulate methods used to prevent contamination. Thus, various flushing/no flushing and sample discarding/no discarding techniques were analyzed. When diluted concentrations of drug were administered, minor artifactual DCs were observed unless the line was not flushed or sample fluid discarded prior to final sampling. With undiluted drug administration, only flushing after the dose and discarding a sample prior to final sampling prevented artifactual DCs. Clinicians should be aware of the potential for such artifactual elevations of DCs and should encourage techniques that prevent their occurrence.
Ther Drug Monit 1991 Sep
PMID:Effect of monitoring drug concentrations through lines used to administer the drugs: an in vitro study. 195 38

A rapid and efficient method for obtaining murine bone marrow cells is described, which yields up to twice the amount of cells obtained by the conventional method of flushing through the bones. The femoral and tibial bones are partially broken by an Omni-Mixer in the presence of phosphate-buffered saline to allow their bone marrow content to extrude into the liquid suspension. Murine bone marrow cells obtained by this method were found to be more than 95% viable, and their differential counts were comparable to those of bone marrow suspensions obtained by the flushing method. Moreover, no contamination by cells from the bone or other surrounding tissues has been observed. Transplantation of bone marrow, obtained by the new extrusion method and depleted of T cells, resulted in long-term stable chimeras in which the hematopoietic reconstitution was comparable to that found in mice transplanted with bone marrow obtained by the flushing method. This new method for obtaining murine bone marrow cells may serve as a time- and mice-sparing alternative to the conventional flushing method, and may also prove useful in other animal models.
Bone Marrow Transplant 1991 Sep
PMID:A rapid method for obtaining murine bone marrow cells in high yield. 195 3

Sudden hypertensive surges are often observed in patients with primary hypertension. Even though the possibility of a pheochromocytoma almost automatically comes to mind, this diagnosis is confirmed only in a few patients (less than 1%). The case of a 55 yr old patient with very high posture-or emotion-induced hypertensive paroxysms, often associated with chest pain and flushing is described. All laboratory tests were normal except for plasma catecholamines, which were high especially during stress tests (Tab. II). The existence of a pheochromocytoma was excluded on the basis of repeatedly normal urinary catecholamine levels after hypertensive crises and a negative CT abdominal scan and I131 MIBG adrenal scintigraphy. An alteration of the baroreceptor reflex was ruled out, as the blood pressure response to autonomic function tests was normal. The cause of the orthostatic hypertensive crises could not be attributed to hypovolemia, as plasma volume proved normal. Measurement of circulating catecholamines showed elevated free plasma epinephrine with low conjugated epinephrine indicating a defective conjugation of this amine. This finding suggests an injured inactivation of epinephrine and might be involved in the pathogenesis of the hypertensive crises observed. Continuous intra-arterial blood pressure monitoring demonstrated the existence of mild hypertension with a normal 24-hour blood pressure pattern. However, the tracings were interspersed with numerous blood pressure peaks. Average 24 hour blood pressure was normalized by the therapy, but the hypertensive crises were not controlled by any of the drugs used. The absence of target organ damage despite the spectacular rises in blood pressure suggests that the cardiovascular system is well able to withstand hypertensive episodes if they are short lived.
G Ital Cardiol 1990 Sep
PMID:["Essential" hypertension with extreme pressure variability. Description of a case and considerations]. 207 89


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